Pressure Injury/Ulcer Risk Assessment: A Patient-Centered Approach Protection Status
Blog Category: 
Patient Centered Risk Assessment

by the WoundSource Editors

The goal of pressure injury/ulcer prevention is not only to maintain skin integrity but also to provide a patient-centered plan of care geared toward positive outcomes. This includes seeing your patient as a person, as well as identifying the patient’s pressure injury risks. Caregivers of any kind should learn to take steps in the prevention of pressure injuries/ulcers. We can utilize every risk assessment and tool known, but without educating our patients, health care professionals, and caregivers, a prevention program will not be successful. And let’s not forget that pressure injuries/ulcers can occur in patients of any age, at any weight, and in any type of setting. Most people think nursing homes are to blame when they hear the terms pressure ulcer, pressure injury, sore, decubitus, and bedsore. As clinicians, we tend to focus on the patient groups we take care of. Pressure injuries/ulcers are, most of the time, preventable.

Develop a Comprehensive Pressure Injury Risk Management Program

Developing specific policies and procedures related to pressure injury prevention and treatment will provide a strong, structured prevention program. Using a validated risk assessment tool such as the Braden Scale for Predicting Pressure Sore Risk® or Pressure Ulcer Scale for Healing (PUSH) tool is imperative for predicting pressure injury/ulcer risk. Risk assessment tools and frequency used vary by health care setting. For example, long-term care facilities may screen for pressure injury/ulcer on admission, readmission, change in condition, and with each minimum data set (MDS) 3.0 assessment.1

Your facility should have an algorithm in place for prevention and treatment of pressure injuries/ulcers. Here are a few questions to ask yourself when evaluating your risk assessment process.2

  1. Do you have interventions in place that can be immediately implemented for patients with low, moderate, and/or high risk of pressure injury/ulcer development?
  2. Do you have the necessary equipment to implement these interventions, such as redistribution mattresses, offloading heel devices, seat cushions, positioning devices, turning pads/slings for bariatric patients, etc.?
  3. Do you have a protocol for patients with medical devices? These patients should be considered high risk.
  4. Do you have daily, weekly, or monthly skin checks at your facility?

The Pressure Injury Risk Assessment Tool Focus

The following items detail common risk factors for developing pressure injuries/ulcers and contain interventions to help prevent the injury/ulcer from developing.1



If we are proactive with our assessments, we can help prevent the development of pressure injuries/ulcers. Health care providers can help improve patients’ outcomes, reduce complications, and control costs. Listen to your patients, and work together to plan their care. The goal is to reduce pressure injury/ulcer incidence entirely.

1. CMS MDS 3.0 RAI Manual. Centers for Medicare & Medicaid Services. Accessed October 24, 2018.
2. Agency for Healthcare Research and Quality. Preventing pressure ulcers in hospitals. A toolkit for improving quality of care. Accessed on October 7, 2018.
3. Skalsky AJ, McDonald CM. Prevention and management of limb contractures in neuromuscular diseases. Phys Med Rehabil Clin N Am. 2012;23(2):675–87.
4. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers: clinical practice guideline. 2014. Accessed on October 7, 2018.
5. National Pressure Ulcer Advisory Panel. The unavoidable outcome: a pressure injury consensus conference. J Wound Ostomy Continence Nurs. 2014;41(4):1–22.
6. Cock K. Anti-embolism stockings: are they used effectively and correctly? Br J Nurs. 2006;15(6):S4–12.

Suggested Reading
Centers for Medicare & Medicaid Services. CMS MDS 3.0 RAI manual. Accessed September 21, 2018.
National Pressure Ulcer Advisory Panel. Pressure injury prevention points. 2016. Accessed September 21, 2018.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

Recommended for You

  • April 8th, 2022

    By Heidi Cross, MSN, RN, FNP-BC, CWON

    As detailed in my last few blogs, nutrition plays a huge role in risk for skin breakdown as well as healing of wounds. Just about ALL wound litigation involves nutrition in one way or another, be it diabetes control (or lack thereof) or...

  • January 7th, 2023

    By Janet Wolfson, PT, CLWT, CWS, CLT-LANA

    A 55-year-old African American male was admitted to our inpatient rehabilitation facility (IRF) with a right trochanter stage 4 pressure injury, sacral stage 3, and left below the knee amputation (L BKA) with comorbid diabetes mellitus (...

  • November 1st, 2022

    Pressure injuries are injuries to the skin and deeper tissues that occur due to direct pressure, shear, or friction forces. It is estimated that in the United States, 2.5 million pressure injuries occur yearly in acute care facilities alone. The price of managing a single full-thickness pressure...

Important Notice: The contents of the website such as text, graphics, images, and other materials contained on the website ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The content is not intended to substitute manufacturer instructions. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Refer to the Legal Notice for express terms of use.